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최한샘,이순민,은호선,박민수,박국인,남궁란 대한소아청소년과학회 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.8
Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above 23.0˚C, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <36.0˚C) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from 35.5˚C to 36.0˚C. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from 35.4˚C to 35.9˚C and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.
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The toxicogenomic study on Persistent Organic Pollutants (POPs) in human hepatoma cell line
최한샘,송미경,이은일,류재춘 한국바이오칩학회 2013 BioChip Journal Vol.7 No.1
Persistent organic pollutants (POPs) are a major group of contaminants. They are geographically widely distributed, circulate globally, and remain intact in the environment for a long period. POPs accumulate particularly in the fatty tissue of living organisms. Although many chemicals are suspected to have hazardous effects, evaluation of their toxicities remains difficult and challenging. In this study, we used toxicogenomic tools that are simple and economical, as compared to other tools of risk assessment. To predict the risk of environmental toxic substances or compounds, investigation of toxicological mechanisms or biomarkers is important. In this study, we identified hepatotoxicity-related genes induced by three POPs (chlordane, toxaphene, and mirex) in the human hepatocellular carcinoma (HepG2) cell line using microarray and gene ontology (GO) analyses. Using microarray analyses, we identified genes that were up- and down-regulated by greater than 1.5-fold. After the GO analyses, we determined several key pathways that are known to be related to hepatotoxicity, including the metabolism of xenobiotics by apoptosis, complement and coagulation cascades, and cell cycle regulation. Thus, our present study suggests that differentially expressed genes by POPs may provide clues for the hepatotoxic mechanism of POPs. In addition, gene expression profiling by toxicogenomic analyses also affords promising opportunities to reveal new toxicity mechanistic markers.
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Respiratory failure in a diabetic ketoacidosis patient with severe hypophosphatemia
최한샘,권아름,채현욱,서정환,김덕희,김호성 대한소아내분비학회 2018 Annals of Pediatirc Endocrinology & Metabolism Vol.23 No.2
Phosphate is essential in regulating human metabolic processes, and severe hypophosphatemia can induce neurologic and hematological complications and result in respiratory failure and cardiac dysfunction. Therefore, correction of severe hypophosphatemia can be pivotal in the management of diabetic ketoacidosis (DKA). We report the case of a 14-year-old female who was diagnosed with type 1 diabetes and referred to our institute for treatment of DKA. Although the patient received fluid and continuous insulin administration according to the current DKA treatment protocol, generalized tonic seizures and cardiac arrest developed. After cardiopulmonary resuscitation, the patient recovered and was stable. Within 16 hours after DKA treatment, the patient developed respiratory failure with severe hypophosphatemia that required mechanical ventilation. Concurrent neurologic evaluation revealed no specific abnormalities. The patient recovered without any complications after correcting the hypophosphatemia. We suggest vigilant monitoring of the phosphate level in DKA patients and active replacement when required.
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최한샘,김호성,채현욱 이화여자대학교 의과학연구소 2021 EMJ (Ewha medical journal) Vol.44 No.4
A notable secular trend in early puberty onset has been described over the past few decades. Also, the prevalence and incidence of precocious puberty is increasing not only in Korea, but also around the world. The manifestation of secondary sex characteristics before 8 years in girls and 9 years in boys is defined as precious puberty. The causes of precocious puberty can be classified as gonadotropin releasing hormone (GnRH)- dependent, also known as central precocious puberty (CPP), or GnRH-independent. Evaluation of patient with precocity requires detailed examination of the clinical manifestation, GnRH stimulation test, and imaging of the central nervous system if indicated. The standard treatment for CPP is GnRH agonist, which is beneficial for adequate pubertal development and preservation of final adult height. In this paper, we investigate the diagnosis and adequate treatment of CPP.
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electrochemically anodized stainless steel acupuncture needle for activation of vital energy
최한샘,인수일 한국공업화학회 2018 한국공업화학회 연구논문 초록집 Vol.2018 No.0
Acupuncture needle begins to be employed from 6000 BC, which is believed to be utilized with early type such as sharpened stone, bamboo, bone. It is a medical device which converts physical energy to vital energy by needle insertion on skin. A few studies have reported enhanced acupuncture efficacy via modification of diverse parameters such as acupuncture needle diameter, depth of insertion, and needle surface. Inspired by such intriguing results, recently we reported fabrication of nanoporous acupuncture needle (PN). The electrochemically anodized acupuncture needle manifest hierarchical micro/nanos-porous surface. That topographical features, interconnected elastic fibers and collagen strongly, that enhance effective surface area and 'de qi' effect. This naturally activated vital energy is inexplicable. but, it is believed that the effect of acupuncture are mediated through electrical stimulation of central nervous system, leading to reduced tissue inflammation.
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자일로올리고당을 함유한 설탕이 건강한 성인의 Glycemic Index (GI)와 혈당에 미치는 효과
경명옥,최한샘,정상원,이경선,조성은,서승우,최근범,양창근,유상호,김유리 한국영양학회 2014 Journal of Nutrition and Health Vol.47 No.4
Purpose: The objective of this study was to investigate the effects of xyloologosaccharide (XOS)-sugar mixture on glyce-mic index (GI) and blood glucose in human subjects. Methods: Randomized double-blind cross-over studies were con-ducted to examine the effect of sucrose with 14% xyloologosaccharide powder (Xylo 14) and sucrose with 20% xylooligo-saccharide powder (Xylo 20) on GI and postprandial glucose response at 15, 30, 45, 60, 90, and 120 min. Results: GIs of Xylo 14 and Xylo 20 were 60.0 ± 23.5 classified within medium GI range, and 54.3 ± 17.7 within low GI range, respectively. Xylo 14 and Xylo 20 showed significantly lower area under the glucose curve (AUC) for 0-15 min (p = 0.0113), 0-30 min (p = 0.0004), 0-45 min (p < 0.0001), 0-60 min (p < 0.0001), 0-90 min (p < 0.0001), and 0-120 min (p = 0.0001). In particular, compared with glucose, the blood glucose levels of Xylo 14 and Xylo 20 were significantly lower at every time point between 15 and 120 min. Conclusion: The results of this study suggested that Xylo 14 and Xylo 20 had an acute suppressive effect on GI and the postprandial glucose surge. 본 연구는 자일로올리고당을 설탕에 적용하여 임상시험을통해 자일로올리고당 첨가량에 따른 설탕의 GI 저감효과와 혈당저감효과를 확인하였다. 건강한 성인 남녀 11명를 대상으로표준식품인 포도당과 비교하여 분말 자일로올리고당을 14% 함유한 Xylo 14과 분말 자일로올리고당을 20% 함유한 Xylo 20을 섭취 후 표준식품과 비교식품의 IAUC를 통해 GI를 산출한 결과 Xylo 14는 60.0 ± 23.5로 Medium GI 식품으로 나타났으며, Xylo 20은 54.3 ± 17.7로 Low GI 식품으로 나타났다. 순수한 설탕의 GI 68과 비교하면 각각 11.8%와 20.1% 혈당상승 저감효과를 나타낼 수 있었다. AUC는 15~90분까지 모든 구간에서 유의적인 차이 (p < 0.05)를 나타내었다. 따라서Xylo 14와 Xylo 20은 혈당 저감효과를 나타냄과 동시에 7~10 g 이상 섭취하면 자일로올리고당의 1일 유효섭취량도 만족시킬 수 있으므로 기능성 설탕으로서의 활용이 기대된다.
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뇌졸중 환자들의 무기질 (칼륨, 마그네슘, 칼슘) 섭취와 식사의 질 및 대뇌 죽상경화증과의 상관성 연구
손지현,최한샘,황지윤,송태진,장윤경,김용재,김유리 한국영양학회 2015 Journal of Nutrition and Health Vol.48 No.2
뇌졸중은 국내 3대 사인 중 하나로 칼륨과 마그네슘, 칼슘의 섭취량이 뇌졸중 발병 및 예방에 긍정적인 영향을 미친다는 연구가 지속되고 있지만 연구 결과가 아직 명확하지 않은 실정이다. 또한 뇌졸중 환자들에 있어 영양 상태는증상의 정도와 합병증 및 예후를 결정짓는 중요한 역할을함에도 불구하고 현재까지 국내 뇌졸중 환자들의 DQI-I를이용한 식사의 질 평가에 대한 연구는 미비한 실정이다. 따라서 본 연구에서는 285명의 뇌졸중 환자들의 칼륨과 마그네슘, 칼슘의 섭취량에 따라 4분위로 나누어 섭취량이가장 적은 Q1 그룹과 섭취량이 가장 많은 Q4 그룹의 식사의 질을 평가 비교하였고, 칼륨과 마그네슘, 칼슘의 섭취량과 대뇌 죽상경화증과의 상관성에 대해 분석하여 그 결과를 요약하면 다음과 같다. 1) 대상자들의 신체계측 및 생화학적 검사결과는 칼륨과 마그네슘, 칼슘의 섭취량에 따라 차이가 나타나지 않았으나, 연령이 낮을수록 마그네슘의 섭취가 유의적으로 높았고, 교육수준이 높을수록 칼륨의 섭취가 많았다. 그리고칼륨의 섭취가 많을수록 심방세동의 분포가 적었으며, 마그네슘의 섭취가 많을수록 대뇌 죽상경화증의 분포가 적음을 확인하였다. 2) 대상자들의 칼륨과 마그네슘, 칼슘의 섭취량과 한국인 영양섭취 기준28을 비교한 결과, Q1에서의 섭취 비율이Q4에서의 섭취 비율보다 유의적으로 낮았고, 특히 마그네슘의 경우, Q1 그룹과 Q4 그룹 모두 권장섭취량에 비해 부족하게 섭취하고 있었다. 그리고 식품군별 섭취량과 영양소별 섭취량 비교 결과, Q1 그룹의 평균 섭취량보다 Q4 그룹의 평균 섭취량이 유의적으로 많았다. 3) 대상자들의 식사의 질을 비교한 결과, 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 INQ와 MAR, 총 DQI-I의 점수가 높아 식사의 질이 높음을 확인하였다. 4) 대상자들의 칼륨과 마그네슘, 칼슘의 섭취량과 대뇌죽상경화증의 상관성을 분석한 결과, 유의적인 상관관계가 없었으나, 마그네슘의 경우 보정을 하지 않았을 경우와나이, 성별, 교육수준, 흡연량, 심방세동의 유무, 총열량 섭취량을 보정한 경우, 섭취량이 많을수록 대뇌 죽상경화증의 발생률이 줄어드는 경향을 보였다. 결론적으로 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 전반적인 식사의 질이 좋음을 보여준다. 그리고 마그네슘의 경우 섭취량이 높을수록 대뇌 죽상경화증의 발생률이 줄어드는 경향을 보였다. 하지만 DQI-I의 절제성 항목과 균형성 항목에서 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 점수가 낮아진 점과 대뇌 죽상경화증 발생과의 유의적인 관계가 충분하지 않았던 결과를 보아 제한점들을보완하고 대상자수를 충분히 확보하여 지속적인 연구를수행한다면 환자 개인적 차원뿐만 아니라 국가적 보건 차원으로 뇌졸중의 합병증 감소 및 예방에 기초자료를 제공하는 데에 도움이 될 것이라 사료된다. Purpose: This study was conducted to evaluate the association between intakes of potassium, magnesium, and calcium and diet quality in ischemic stroke patients. Methods: This study analyzed data from 285 subjects recruited from February 2011 to August 2014 in Seoul, Korea. Nutrition intakes were obtained from a semi-quantitative food frequency questionnaire composed of 111 food items. The subjects were divided into 4 groups by quartiles according to intakes of potassium, magnesium, and calcium. Index of Nutritional Quality (INQ), Mean Adequacy Ratio (MAR), and DQI-International (DQI-I) were analyzed for assessment of diet quality. Results: We found a positive association of intakes of these three minerals with MAR and DQI-I after adjustment for age, sex, education level, smoking, atrial fibrillation, and total energy intake. However, total moderation of DQI-I score in the Q4 group was significantly lower than that of the Q1 group. The age, sex, education level, and smoking, atrial fibrillation, and total energy intake-adjusted odds ratios of extensive cerebral atherosclerosis were inversely associated with intake of magnesium (Ptrend = 0.0204). However, this association did not exist with intakes of potassium and calcium. Conclusion: Potassium, magnesium, and calcium rich and high quality diet could be associated with decreased risk of ischemic stroke, in part, via effect on extensive cerebral atherosclerosis.
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